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Re: low milk supply - have to supplement with formula

Demand is so high with my LO that she sucks me dry during the day, so at about 2 she is fussy/upset because she goes from one breast to the other sucking (but theyre dry), which is what leads me to give her the formula. I feel like ive tortured her but basically shes "pumped me dry", but ive got to wait a few hours to have more for her. This is when i just feel horrible cause i obviously dont have enough for her. Maybe part of this is the growth spurt she is having as we get to week 6? Nonetheless, I've got enough at night, but not during the day when she is craving more.

Re: low milk supply - have to supplement with formula

I am still not quite following exactly what the weight gain/loss history is.
Can you provide a complete weight check history, from birth, every weight check number with the date baby was weighed?
Indicate when/if a check is done on a different scale from the previous check
indicate which periods were when baby was exclusively breastfed and which periods were with supplementation, and the approximate daily supplement amount?

indicate the approximate total nursing sessions per day, and note any periods that went up or down sigificantly. Estimated, as needed.
And give an output (poops) history as well? Estimated, as needed.

Re: low milk supply - have to supplement with formula

Originally Posted by @llli*marissa.basch

I feel like ive tortured her but basically shes "pumped me dry", but ive got to wait a few hours to have more for her.

Thinking that you need to wait for your breasts to "fill up" is one of the most common breastfeeding management errors. The breast is never really empty because milk is always being made. The emptier the breast gets, the faster milk is made to replace what is being taken out. And conversely, the more full the breast gets, the slower milk is made to replace. So as long as a baby is allowed to nurse on demand, that baby should be able to get milk out of even an "empty" breast. Maybe the milk won't come out as fast as baby likes, but if she is allowed unrestricted access to the breast she will eventually get her needs met.

Cluster feeding in the afternoon/evening is textbook normal for babies this age. During cluster feeding, the baby will be extra fussy and want to nurse either nonstop or with very short breaks.

Re: low milk supply - have to supplement with formula

So, I do see here a history or slower than average gain. What do you guys think?

BUT I notice that even with a very small amunt of formula, the gain jumps dramatically, from very slow, to very good. The first time you supplemented, it was with 6 ounces a day, which would be about a third of normal intake for that age.

And this last time, it was only 2 ounces per day of formula-a tiny fraction of the 25 ounces or so a baby over a month old would normally be taking in, and baby gained 5 ounces in 4 days! One ounce per day would be excellent weight gain.

Maybe your baby just got a slow start with the growth, or tends to grow in fits and starts (normal) or your supply was low, but with the galactagogues, all is doing fine now? I do not see how 2 ounces a day of formula alone would make such a dramatic difference in weight gain.

I BF on demand so when EBF there isn't much of a break between feedings (20 minutes), she eats all day. I feed at least 8 times a day.

There is only a 20 minute break between feedings every time or almost every time, yet baby is nursing 8 times a day? How long (what duration of time) is baby nursing for?

Becasue 8 times a day is a minimum for the early weeks. It is the very least a baby might typically nurse to get enough. Most babies must nurse more often than that.
But if your baby always has extemely long feedings, with the slow gain, that would indicate a milk transfer issue. And if baby has a milk transfer issue, that can also deflate production.

Re: low milk supply - have to supplement with formula

Lets go night to day. This is just an approx because i do whatever my LO wants.

11pm/12am breasts are full- feeding is done for about 20-30 minutes (LO falls asleep)
2/3am breasts are full - same time schedule (LO falls asleep)
5/6am- same as above
9/10am - same as above (wake-up time)
11:30am/12:30pm - feeds again but breasts aren't as full (some napping happens here and she wakes up wanting to eat) may take some then fall asleep
1:30pm-3:30pm - same as above (breasts aren't full feeling) she may take some, nap, take more, nap (but naps are 20-30 mins)
4-6pm - she asks for milk, i give it (breasts aren't full feeling) she takes some, i give her the other breast (but she is fussier now than earlier in the day)
7-8:30pm - bathtime/bedtime - she gets each breast until she goes to sleep.

So that's eight times BUT...sometimes (at lets say 11-12:30) she'll nurse for 15 minutes, nap, then nurse again (so that counts as two right?) It's on demand - if she wants more i switch breasts are give her more till she is happier.

She does, however, regularly fall asleep on the breast, so i have to switch breasts a few times, and therefore nursing takes longer.

Re: low milk supply - have to supplement with formula

So that's eight times BUT...sometimes (at lets say 11-12:30) she'll nurse for 15 minutes, nap, then nurse again (so that counts as two right?)

Yes, in my book, that counts as two. Not that this is an exact science.

So, I am not seeing why you say you cannot fit more sessions in. From what you have posted, I see spacing of approximately three hours from the start of a feeding to the start of the next. That leaves spaces of time in which to offer the breast more, unless feedings are three hours long. If baby is sleeping the whole time between feedings, then what about encouraging baby to nurse in his sleep? Sometimes just making a habit of holding baby while baby sleeps much of the time and offering the breast when baby stirs or makes cues during sleep will increase frequency of feedings.

Now, if you are pumping, and supplementing, aka, “triple feeding.” that certainly makes things more time crunched.

But I am not saying nurse 6 times a day more. I am suggesting, maybe, 1-3 times a day more. Or whatever. If you offer and baby refuses, then that is that (for the moment.) You cannot make a baby nurse. But it never hurts to offer.

Right now you are supplementing 2 ounces a day. 2 ounces would be typical intake for one fairly good feeding. So if you can squeeze even one more feeding in a day, you might be able to eliminate the supplement. If you start eliminating the supplements, you can start eliminating pumping. Life gets easier.

Moms do not have to wait a certain amount of time between feedings in order for the breasts to fill up. Just in case you were under that impression.

While I have never heard of a mother who can only make enough milk for baby part of the day, this does not mean it can not happen. If this seems to be your situation, perhaps you can talk to an IBCLC specifically about that. This is just wild speculation, but maybe it has to do with some hormonal thing that causes unusually dramatic milk production fluctuations by time of day?

Re: low milk supply - have to supplement with formula

with LLLMeg. Squeeze in just a few more feedings, and see what happens.

It does seem like there's a history of slow gain here, and the question is why? Excessive sleepiness? Difficulty with milk transfer? Baby giving such subtle hunger cues that you're missing them? Some medical issue preventing you from haing a good supply (e.g. PCOS, thyroid issues)? I'd be curious to see what a few weigh-feed-weigh measurements would show. If baby's average feeding is over 2 oz, then the issue is probably that baby just isn't nursing enough. If it's under 2 oz, then it could be a milk trasnfer problem.

Fussy evenings are really common with young babies, and evening fussiness can often make moms think that the problem is that there's no milk. For example, if the baby is pulling off the breast and crying, that can seem like the baby's trying to say "No milk! I'm starving!" But more often the baby is trying to say "Wah! I'm cranky! Nothing is making me happy right now! Find a way to make me happy, Mom!"

Some things you can do for fussy evenings:
- Nurse. Nurse nurse nurse nurse nurse. Baby can't scream with a breast in her mouth.
- Calm house. Lights, TV, and stereo down or off.
- White noise. Radio static, dryer sounds, noise machine.
- Closeness. Snuggle baby close in a sling.
- Motion. Bounce baby on exercise ball, put her in a swing, take her for a stroller ride.
- Swaddle.
- Warm water. Give baby a bath in the sink or take a bath with her.
- Trip outside into he fresh air.
- Bottle...? With my first kid, a nightly bottle was part of our routine. I would attempt to nurse her, and then if she went into colicky freak-out mode, daddy would give her a bottle while I pumped for the next night's bottle. Since my supply tended to be a bit low at that time of night, it sometimes took an additional pump session to get 2 oz. Using bottles was a temporary measure for us- babies outgrow the fussy evening phase and by 3 months I could simply nurse.

You're doing a great job, mama! I know this sort of experience is frustrating and makes you doubt your ability to nurse successfully, but it sounds to me like you're very close to metering this breastfeeding thing.

Re: low milk supply - have to supplement with formula

So I weighed my lo last Tuesday and she had only gained 3ounces. That told me that its time to give her more formula. I have been bf then giving 2oz of formula our maybe 1.5 and she is very satisfied.in fact when I go to burp her after the formula she kind of cries wanting more. She also refuses the breast at times because of an over active let down. When I pump at my fullest I get 2 oz total at most which I believe tells me that I'm not making enough. So now...when I pump? I want to have something stored each feeding and not pump.between feedings but...I'm not sure what else to do. I'm weighing her tomorrow again and will post her weight, but I've been giving her formula four times a day so I'm sure she gained weight.